By Norman E. Kjono March 1, 2004

In 2001 Washington voters passed Initiative 773, a new 60 cents per pack tax on cigarettes. The Initiative was sponsored by the American Lung Association of Washington (see ALAW Fall 2001 Annual Report.) Page 2 of that 2001 Annual Report stated “An independent analysis calculates that I-773 will increase funding for health care services by $135 million per year.” Two statements on page 3 of the association’s 2001 report are of interest and importance:

 “This year we advocated for adequate funding of the state’s Tobacco Prevention and Control Plan. We mobilized hundreds of citizens through our legislative network. LegNet members contacted their legislators, and as a direct result of our efforts, the legislature appropriated $17.5 million per year for the biennium.”

 “The American Lung Association of Washington has been the driving force behind Initiative I-773. We mobilized our staff and volunteers to help gather signatures to qualify the Initiative for the November ballot.”

According to the initiative 90 percent of I-773 funds were earmarked to provide expanded health insurance for the poor and 10 percent were designated for tobacco control programs. Immediately after I-773 was passed the raid on funds began. In its December 18, 2001 press release “Gary Locke Thwarts Voters; Raids Tobacco Fund”  the American Lung Association of Washington vented its rage at Governor Locke transferring $21.2 million from the tobacco prevention and control account to the state’s general fund in a proposed budget (assuming that the tobacco control funding would be replaced by the 10 percent of I-773 revenues earmarked for anti-tobacco.) That press release also claimed that I-773 revenues would be used to expand Washington ’s Basic Health Plan enrollment to 145,000 participants by 2003.

It appears that neither funding application was the case: as noted below the American Lung Association is now happily using I-773 money to promote smoking bans and the state’s working poor have experienced funding intended to expand the Basic Health Plan being diverted by legislators to the general fund. In hindsight I-773 shakes out to be simply a way for tobacco control operatives to bait the comparatively wealthier nonsmoking majority into taking a tax free-ride on their lower income smoking neighbor’s nickel, while switching the working poor onto a dead-end track of reduced Basic Health Plan coverage once the tax revenues began to flow.

In keeping with the theme of “Take Their Money, Not Ours” the lung association published a particularly shrill whine about how poorly states are funding professional activist tobacco control programs that provide a large portion of anti-tobacco’s munificence skimmed from the public trough, through its publication of “State of Tobacco Control: 2003.”  Readers should spend a few minutes perusing the Executive Summary for that report. It immediately becomes apparent why the association says it does not guarantee the accuracy of information in that report because it is nothing more or less than a political puff piece used to bully legislatures into sustaining funding for its own programs and agendas. The association publishes its judgmental pronouncements of states’ conduct by grading them like elementary school children form F to A based on how well each state complies with their tobacco settlement revenue and smoking ban agendas. Washington was awarded a B by the association, which undoubtedly accounts for the mean-spirited, shrill and unending demands of anti-tobacco in our state today. About 35 states were awarded an F by the association, which may be a good indicator of states that are on the higher end of civil culture where normal people can live in relative peace. Interestingly, there is nothing in the lung association’s 2003 report that decries ripping off lower income smokers with new and regressive cigarette taxes to fund expanded health care that is not being delivered by the state.

As it turns out, not only have the state’s working poor failed to received the I-773 funding earmarked to extend the state’s Basic Health Plan but they are now being asked to pay more for their Basic Health Plan participation! From The Seattle Times, March 1, 2004, “Health-Care For Poor Kids Causes Split,” by Associated Press Writer Rebecca Cook:  

“Many Washington residents easily part with $5 a day at their local coffee shop. For others, $5 means they'll be able to buy groceries, pay the electricity bill, or get school supplies for their children. In the next 10 days, legislators will decide whether poor families can afford $5 a month in Medicaid premiums for their kids. Both sides of the debate agree it's a question of responsibility. Republicans say poor families should take responsibility for paying at least something for their children's health care. But Democrats say premiums will force families to drop out of Medicaid. They argue the state should take responsibility for making sure poor kids get health care.”

Ms. Cook also reported:

“When they passed their budget last week, Senate Republicans defeated an amendment that would have eliminated the premiums. Going to the House budget plan would add $6.5 million to the Senate budget. Sen. Joe Zarelli, R-Ridgefield, the Senate's chief budget writer, says taxpayers can't afford to give Medicaid families a free ride. He noted that premiums wouldn't cost more than 1 percent of Medicaid families' income. He and other Republicans said they believe parents will be able to pay. ‘Just because people are poor does not mean they are stupid,’ Sen. Linda Parlette, R-Wenatchee, said on the Senate floor. ‘I am sure they will choose to have their children covered by health care and pay that premium rather than having a Big Mac at McDonald's.’” (Underline, Italic added.)

            A scant biennium after special-interests successfully promoted a new tax on cigarettes that was to raise $135 million for additional health care funding we read in The Seattle Times that Republican Senators are crying poor over the $6.5 million “cost” of not charging poor people more for Basic Health Plan coverage. Three years after professional activist had no trouble at all raising $17.5 million per year for their pet peeve cause we hear from a member of the Washington Senate that poor folks can choose between a Big Mac and health care.

            A related report was published by The Seattle Times June 8, 2003 in its recap of legislative outcomes for the 2003 legislative session “Adding Up The Winners And Losers,”  by Ralph Thomas. Mr. Thomas reported last June:

“Health care for the poor: These were supposed to be boom times for the state's Basic Health Plan, which provides subsidized health care to 122,000 low-income people, mostly adults who don't have private insurance but make too much money to qualify for other public assistance. Voters in 2001 approved I-773, which sharply increased tobacco taxes and earmarked the money for as many as 50,000 new enrollees in the state's Basic Health Plan (BHP). But lawmakers instead amended I-773 so that they can put the new tobacco money toward the deficit and cap BHP enrollment at 100,000. Some poor people will also get pinched by the Legislature's plan to start charging monthly premiums ranging from $15 to $25 per child for families on Medicaid. Legislative budget analysts estimate 20,000 children will get bumped because their families can't afford or refuse to pay the costs.

Citizen initiatives: As you might have gathered, initiatives took a real beating. We've already mentioned plans to suspend the teacher-pay measure (I-732), slap down the home-care workers contract (I-775) and raid the new tobacco money that was intended for increased BHP slots (I-773). Lawmakers also tweaked I-728, which voters approved in 2000 to steer more state money toward class-size reduction efforts. Under the new budget, school districts will get less than a quarter of the $221 million in new class-size money they were supposed to get during the next two years.”

According to senator Parlette, poor folks should make a “responsible” choice between buying a Big Mac or paying the state! Were it not for Washington’s 60 cents-per-pack new cigarette tax passed in 2001 under I-773 – 90 percent of which was required to be dedicated to expanding health insurance for the poor – perhaps some could argue that poor families contributing a small amount to their family’s Basic Health Plan costs has merit. Problem is that by tobacco control’s own demographics, lower income, less educated, Blue Collar workers are by far the largest population of persons who smoke. That same “Target Group” population also pays the lion’s share of I-773 taxes. So the population group that Senator Zarelli wants to charge for Medicaid premium co-payments, and the group that Senator Parlette opines should choose between food and Medicaid premium co-payments, is already paying discriminatory taxes on tobacco products – with a large portion of that tax ostensibly dedicated to paying for their health care. Those cigarette taxes were passed based on the pretense that the majority of revenues would be dedicated to providing expanded Basic Health Plan insurance coverage. Maybe Washington legislators should vote to divert some of I-773 tobacco taxes to subsidize ketchup, as a “vegetable” that will improve poor folks’ fast food diets, too. (Oops! I forgot that ketchup is already available free with a Big Mac, so there’s no need to divert state revenues for those purposes, either.)

Discriminatory taxation of lower income families is reduced, however, to rank bait-and-switch elitist fiscal opportunism when we consider that application of I-773 funds as specified in the initiative has been diverted by our legislature from its intended use, to be applied instead to decrease the state deficit. Having voter approved-funding that would provide more than enough revenue to finance not charging a $5 Medicaid premium co-payment – funding that many Medicaid recipients already pay cigarette taxes to support – pulled out from under them by our state legislature in 2003, the working poor are now informed by legislators in 2004 that they are on a free-ride if they ask to avoid paying even more for Basic Health Plan coverage. Which raises an issue about one of the most unseemly lows in political rhetoric that we have seen in decades: the same politicians who ripped off funding approved for voters to pay for expanding the state’s Basic Health Plan now righteously demean those with reduced health care as being on a free ride if they don’t pay even more for less coverage. 

So what is tobacco control using their 10 percent of  I-773 funding for? Washington Department of Health’s January 2003 press release “State Department of Health awards $1 million in grants to fight tobacco use and exposure to secondhand smoke”)  provides an answer. The press release says contact for that program is Tim Church, Office of Communications 360-236-4077. Judging by the content of our latest round of smoking ban promotions, tobacco control money is being used to negatively label, unfavorably stereotype, vilify as “killers,” and stigmatize persons who smoke – in large part Medicaid recipients – to justify ostracizing them from the mainstream of public participation. It appears that legislators not only want such folks to pay more for reductions in the state’s Basic Health Plan, but they also want the rabble to be a comfortable 35 feet or more away from the front door, too. Why, we can’t have low-lifes cluttering access of legislators and special-interest activists to the hallowed halls of Democracy!  Permitting congregation of the unworthy about the doors of Democracy would reduce the rate at which special-interest elitists can loot them (not to mention that at least 90 percent of the anti-tobacco activists entering the building would instantaneously drop dead from cancer, heart disease, and a host of other ailments by just thinking about the possibility of maybe encountering a whiff of tobacco smoke.)

Not to worry, however. When one reads the health department’s January 2003 press release, a solution to the legislature’s apparent conundrum about providing $6.5 million for health insurance coverage becomes immediately apparent:

“The grants are targeted to raise awareness about the dangers of secondhand smoke and to help reduce tobacco use among minorities and 18- to 24-year-olds — the latest target of tobacco company advertising. The $1 million in new grants is in addition to more than $5 million local communities have already received from the state this year to fight tobacco use.”

            That solution is to stop spending “$1 million in new grants . . . in addition to more than $5 million local communities have already received” on promoting smoking bans that violate state law, bans promoted by salaried state employees and well-heeled professional activists who already enjoy generous fringe benefit packages that include comprehensive health care. Moreover, the funds are readily available from the precise special-interest tax on cigarettes – Washington ’s I-773– that was passed by the people to provide health insurance for the poor. And the amount required, $6 million-plus, even matches. In other words, take revenue already available from the elitists’ tax free-ride on lower income, less educated, Blue Collar worker’s nickel and apply it to the uses approved by the voters in 2001.

Washington tobacco taxes add more than $300 million per year  to state revenues, including those received for I-773. Adding 2002 ($302,336,775) and 2003 ($329,626,671) tobacco taxes reported by Washington ’s Department of Revenue produces a total of $631,963,446 for those two years. Those figures also reveal that from 2002 to 2003 Washington tobacco tax receipts increased by $27,289,896 (+9.0 percent.) What is interesting about that increase is that all of it and more (a total of $44 million) went to increased funding for the state’s Health Services Account. How is it possible that we could have an estimated $135 million in new annual cigarette taxes approved by voters through I-773 in 2001, and add $44 million to Health Service Account funding in 2003, yet be unable to find a relatively mere $6.5 million to fund health insurance coverage that many working poor Medicaid recipients are already paying for discriminatory tobacco taxes for?

Medicaid families are not on a free-ride, as Senator Zarelli claims. Smokers, including a disproportionately higher number of Medicaid families, are already providing a two-thirds of a billion dollars per biennium tax free-ride for Senator Zarelli’s more affluent elitist constituents that do not smoke.

            To say that the state is short of funds to provide for new programs is a subject that can be argued on its merits. But to pass a tax on Washington residents who, by tobacco control’s own demographics, tend to be Medicaid recipients more often than not, to divert funds from a specified purpose to provide health care for the poor, and to then claim in the press that those from whom money is being diverted are on a “free-ride” is specious in the extreme. Senator Zarelli should eat his own math: he states that the proposed Medicaid premiums are 1 percent of  Mediciad families income, but a reported cost of $6.5 million associated with not charging Basic Health Plan premiums to working poor families is also 1 percent of the biennium’s gross cigarette tax receipts, too. Suck it up, Senator Zarelli, you can find that one percent because it’s already being paid by smokers. Trade in your Tofu, brie cheese, truffles, and liver pate’ for a Big Mac, Senator Parlette, you’ll find that you can afford to give up your free-ride on your fellow citizen’s tobacco tax nickel.

Based on its past track record of increasing youth smoking rates and stabilizing adult prevalence through Project ASSIST tobacco control is not a public health service at all. Beyond its transparent and now-predictable service to a pharmaceutical nicotine special-interest mercantile agenda tobacco control advocacy has become an elitist cult mentality run wildly amok. It appears that as long as there is sufficient money to spend demeaning “addict” smokers elitists can maintain a sufficient anti-tobacco smoke-screen to keep looting them. What would Senator Parlette have Medicaid families eat in place of a Big Mac, cake? My personal view is that the State of Washington should immediately strive vigorously to achieve an F- on the American Lung Association’s juvenile report card. Perhaps by doing so we will return to a culture in our state of at least not proclaiming those who legislators and their well-heeled activist cronies target for regressive taxes to be on a free-ride.